Healthcare Provider Details

I. General information

NPI: 1568839058
Provider Name (Legal Business Name): SHEEBA GEORGE MS, APRN,ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2015
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12316 EVENING BAY DR
PEARLAND TX
77584-8827
US

IV. Provider business mailing address

6565 FANNIN FONDREN 270
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 908-420-5379
  • Fax:
Mailing address:
  • Phone: 713-441-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP128739
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP128739
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: